Wiki SNF billing/charges

[nprayer2]

I work for a podiatrist that did a surgery on patient that required the patient to rehab in a SNF center. The dilemma being, when the patient was seen here for f/u, Medicare denied claim for pos because pt was still in SNF.

How can the physician be compensated for services rendered: pt was seen in our office but was still considered in SNF.

Also, can a podiatrist go to the SNF to do f/u to surgery care instead of seeing the patient at the office and incurring a denial?

 

[mitchellde]

I work for a podiatrist that did a surgery on patient that required the patient to rehab in a SNF center. The dilemma being, when the patient was seen here for f/u, Medicare denied claim for pos because pt was still in SNF.

How can the physician be compensated for services rendered: pt was seen in our office but was still considered in SNF.

Also, can a podiatrist go to the SNF to do f/u to surgery care instead of seeing the patient at the office and incurring a denial?

You always use the POS of where the patient is registered as a patient regardless of where the service takes place. So even though the patient was in your office, they were a registered SNF patient so you use the SNF POS not office.

 

[Ape]

Check out split billing if they are in Part A stay. Bill the tech to the NH and the prof to Medicare


Hope this helps! Certainly a
Learning curve with this even to the most seasoned biller!

 

[angelyauman]

If the patient was seen in the physician office you have to use the POS/11, you cannot use the SNF as the POS because the services were not rendered there. You need to bill the technical component (TC modifier) to the SNF and bill the professional component (26 modifer) to Medicare.

 

[mhstrauss]

If the patient was seen in the physician office you have to use the POS/11, you cannot use the SNF as the POS because the services were not rendered there. You need to bill the technical component (TC modifier) to the SNF and bill the professional component (26 modifer) to Medicare.

E/M services do not have a 26/TC breakdown. Debra is correct; physician services provided to a patient that is registered inpatient must be billed with the SNF POS, even if performed in the physician's office.

https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/Index.html